Study to Predict Lymph Node Metastasis Burden in Small Papillary Thyroid Cancer Using Contrast-Enhanced Ultrasound

What this Trial Is About

Papillary thyroid carcinoma PTC is the most common type of thyroid cancer, and many early-stage cases classified as T1N0M0 tumor size 2 cm or less, no clinical lymph node or distant metastasis are being diagnosed due to widespread use of ultrasound. The burden of central lymph node metastasis CLNM greatly influences individualized treatment plans, as different levels of metastasis require different surgical approaches. Conventional imaging methods have limited accuracy in detecting CLNM, leading to possible overtreatment or undertreatment of patients with T1N0M0 PTC. This multicenter retrospective study enrolled 600 patients with T1N0M0 PTC who underwent surgery between June 2018 and June 2025. Before surgery, all patients had dynamic contrast-enhanced ultrasound CEUS of the thyroid and lymph nodes, which provides detailed real-time images of tissue blood flow. Experienced ultrasound physicians analyzed CEUS features to predict lymph node metastasis burden, dividing patients into high-burden, low-burden, and non-metastasis groups. The study used statistical models to identify key CEUS predictors and created a combined model to assess diagnostic accuracy. Participants had their CEUS images analyzed independently and their lymph node status confirmed by pathology after surgery. The study measured the models accuracy using area under the curve AUC and other diagnostic values like sensitivity and specificity. Researchers also evaluated the clinical usefulness of the model to better guide treatment decisions. This approach aims to improve preoperative assessment of lymph node metastasis burden, enabling more precise and personalized treatment for patients with T1N0M0 PTC.

Preoperative Prediction of Lymph Node Metastasis in T1N0M0 Papillary Thyroid Carcinoma by Using Contrast-enhanced Ultrasound